Capturing and Fixing Errors in your Podiatry Billing Procedures to Avoid Medical Audits

March 25, 2015

Podiatry billing is a highly specialized process with detailed and specific codes corresponding to the several ankle, toe and foot treatments. The billing requires compliance to very precise guidelines and policies. It also requires the changeover to ICD-10 coding in addition to codes for various surgical and medical procedures. Moreover, the swiftly changing and updating billing codes for Podiatry further complicates the matter for all those in Podiatry practice. Any errors in the billing lead to increase in cost due to incomplete claims. The physicians, as a result, suffer delayed or denied payments, legal issues, heavy fines and increased risk of medical audits. According to a recent analysis, as many as 49% of the Medicare claims contain errors, which translates into hampered financial growth for the physicians.

Podiatry billing services can avert these errors and significantly decrease the probability of medical audits. The services take care of some common errors that tend to occur during the process, generally due to inaccurate recording of information, like,

  • Coding Errors:
    These types of error occur due to inaccurate recording, registering and tracking of codes when the provider’s office submits incomplete claim. Lack of information leads to application of the wrong medical diagnosis codes to treatments and procedures, including mismatched treatment / diagnosis codes, up-coding (billing code changed to one which represents more serious treatment or diagnosis), down-coding (value and code of a claim reduced) and unbundling (which means listing items separately making the medical bill a lot higher).
  • Duplicate Billing
    As self-explanatory, the error occurs when a single patient is associated with multi-medical records, risking patient’s safety.
  • Incorrect Patient Information:
    Any misspelling of name or a typo also leads to claim rejection by the Payers.
  • Documentation:
    Non-maintenance of complete and accurate clinical documentation and medical records is also one of the major reasons that invite medical audits

According to NerdWallet’s estimate, American hospitals provided over $50 billion worth of “uncompensated care” in 2014. The study apparently referred to the hospital care for which no payment was received by the provider’s office from either the payers or the patients. Indeed, a substantial amount of loss of revenue at the end of physicians, which could have been easily reduced to bare minimum, as follows:

  • Verification and validation:
    The services undertake verification of insurance details by experienced team through web or calling to collect the copays and deductible shares. Also implementing automatic insurance verification feature in EMR for quick self-check at the front desk of provider’s office significantly reduces inpatient registration errors.
  • Coding Solution:
    Podiatry billing services implement highly accurate coding system where a team of qualified and experienced professionals diligently inputs CPT and ICD codes from medical transcripts or super bills. The team also tests the compatibility of diagnosis and procedures codes, does manual re-check and random quality audits, thus decreasing claim submission time and ensuring 100% clean claims submission.
  • Revenue Cycle Management:
    The services also implement an end-to-end revenue cycle management, including cash posting and EOB processing along with denial management and insurance follow-ups.

Podiatry Billing is tricky and is prone to many errors, which primary occur due to inaccurate recording of information in the claim. We here at MedicalBillersandCoders.com ensure that the Podiatry bills are complete in all respects and accurately filled-up for timely and clean claim submissions. Contact us today if you are facing issues with your podiatry billing & revenue cycle management.


Category : Best Billing and Coding Practices